Table 4 Key Themes- Health Provider Capacity

Skill set

I know that’s sensitive, but you have to be prepared to do that and link people up proactively, seek a good GP that’s able to do stuff, rather than say, let’s try and make links with your GP when your GP isn’t either interested or able to do it. (Paediatrician district hospital)

The reason she was in ICU was that the family don’t have a GP, if they have to they go to a medical centre and she describes it as just too difficult, they never know what to do because she’s so complicated, they just see her, and they don’t know what to do. So, she did not get her flu vax, her 2 ½ week stay in ICU was due to influenza type A, completely preventable. She also says that she hadn’t had any of the normal check-ups, she hadn’t had just her basic nutritional bloods done in dot years. There was just all of these little things that had fallen through the cracks for this beautiful young girl (Paediatrician paediatric hospital)

Also, we should have some sort of education system how to take proper care of the complex, either GP or health professional, there’s some kind of training system. We know the complex problem, but there’s a difficulty in getting the knowledge (Paediatrician district hospital)

Resources- time availability

But [even] if you’ve got a good GP, we can’t just spend ½ the day to do a case conference with 2 min’ notice …… and certainly in rural areas, we’re on call and there are days when it just doesn’t work. (GP regional) Many GPs are so busy, they don’t have the time to talk to you and see the information. And again, it’s the situation of where they have a full waiting room and they don’t get paid for the time that they’re spending ……and so sometimes it’s like really hard to put your foot in the door and to be able to help because it’s a shame, because sometimes you can spend a lot of time going around organising case conferencing and then in the end you’re not able to get the GP there. (Community Nurse urban) I always manage to convince the parents to scrimp and save to see the specialist, because 2 years waiting is ridiculous for that child with immense problems with speech to at least have an assessment and get some ideas of how they can help the child. (GP urban)